Abortion rights advocates are on a ballot initiative winning streak. 2024 could change that

By Arit John, Steve Contorno and Michelle Shen, CNN

(CNN) — Abortion rights advocates are hoping to build on their winning streak this November, when ballot initiatives could restore, protect or block access in more than a dozen states.

But nearly two years after Roe v. Wade was overturned, the path to victory has become more complicated for organizers as they navigate a wider range of state laws, new efforts from Republicans to keep abortion off the ballot and internal struggles within the movement over policy and strategy.

Those factors have converged in Florida, where the state’s conservative Supreme Court approved this week the wording of a proposed amendment that would enshrine abortion access into the state constitution despite a legal challenge from the state’s Republican attorney general.

Other initiatives are still in the early phases of gaining ballot access. In Arizona, Arkansas, Colorado, Montana, Missouri, Nebraska, Nevada and South Dakota, efforts are underway to advance ballot initiatives that would restore or expand abortion access. In states that don’t allow citizen-led initiatives, a handful of legislatures are also working to advance measures to expand, protect or restrict access, with mixed results.

For abortion rights advocates, state ballot initiatives are part of a broader strategy in what they view as a long road to restoring federal abortion access.

“It’s going to take us many decades to fully restore and reimagine a federal right to abortion,” said Sarah Standiford, the national campaigns director for Planned Parenthood Action Fund. “But the important thing is that the initial opportunities and needs are really that we go state by state to restore, protect, and ultimately expand access.”

National Democrats also view abortion rights ballot initiatives as opportunities to boost campaigns for president, Senate and more than a dozen US House seats.

In Arizona, a presidential and Senate battleground where abortion is restricted at 15 weeks, abortion rights advocates are collecting signatures to get a vote on an amendment to protect the procedure before fetal viability, which doctors believe to be around 22 to 24 weeks of pregnancy.

In Montana, where Democratic Sen. Jon Tester is vying for reelection in one of the most competitive races on the map, advocates are in the process of finalizing ballot measure language before launching a signature-gathering campaign.

And in Florida, the approval of the ballot initiative sparked a burst of Democratic optimism that the once-purple battleground could turn blue again – despite GOP victories in the 2022 midterm elections, when Republican Gov. Ron DeSantis was reelected by 19 points and Republicans won Miami-Dade County – a former Democratic stronghold.

A political game changer

The Biden campaign declared Florida “winnable” following the simultaneous state court decisions and former Democratic Rep. Debbie Mucarsel-Powell, who is running for US Senate, called the news a “game changer.”

“Across the spectrum, Americans agree that they deserve the freedom to make their own decisions about their health care, and when reproductive rights were at stake, Democrats have won up and down the ticket in states across the country,” DNC deputy communications director Rhyan Lake said in a statement.

But even if Democrats make gains in the state, Florida presents a unique challenge for abortion rights advocates.

Unlike other states, where a simple majority determined the outcome of referendums, ballot measures need to eclipse 60% of the vote total to pass.

It’s also an incredibly expensive state to launch persuasion campaigns. Three of the state’s 10 media markets – the Tampa Bay region, metro Orlando and Miami-Ft. Lauderdale – are also among the 20 largest in the country, and are especially pricey to advertise on television. Organizers raised and spent nearly $16 million in 2023 just to collect the nearly 900,000 signatures – including at least 8% of the 2020 vote total in half of the state’s 28 congressional districts – required to get on the ballot.

Those factors are among some of the reasons national groups ultimately provided little assistance to organizers determined to get abortion access on the state’s ballot this November, multiple people involved with the effort here told CNN.

There were persistent doubts, too, that the conservative state Supreme Court, with five of the seven justices appointed by DeSantis, would allow the measure to reach voters this fall. But on Monday, they approved the language for the ballot in a 4-3 decision.

Still, progressive ballot measures have a track record of recent successes in Florida despite the state’s conservative leaning. Florida voters approved medical marijuana in 2016. Two years later, they voted to ban offshore drilling and in-door vaping. In 2020, a year Donald Trump won Florida by nearly 4 percentage points, Floridians narrowly approved a minimum wage increase with just under 61 percent of the vote.

DeSantis on Thursday offered a window into the counter messaging Republicans are preparing to stop referendums to expand abortion access and legalize recreational marijuana in his state.

“Once voters figure out how radical both of those are, they’re going to fail,” DeSantis said. “They are very, very extreme.”

Despite those challenges, Florida abortion rights advocates have cleared two major hurdles: gathering signatures and overcoming legal challenges.

Legal hurdles and policy debates

But new challenges await. In South Dakota, a new law gives voters the right to withdraw their name from a petition to initiate a constitutional amendment. And in Missouri, Republican lawmakers are backing a measure that would enshrine the state’s near total ban into the state constitution.

In Nevada, a presidential and Senate battleground state, organizers have filed two constitutional amendment proposals. The first, which would protect a range of services including abortion, in vitro fertilization, birth control, vasectomies and miscarriage care, was blocked by a district court judge who ruled it was too broad to qualify under the state’s single subject rule for initiatives. The state Supreme Court is expected to rule soon on the measure.

A second measure, which just covers abortion, was cleared by the same judge. Organizers have gathered 110,000 signatures for an initiative to enshrine abortion access in the state constitution, said Lindsey Harmon, the president of Nevadans for Reproductive Freedom. The committee must submit nearly 103,000 valid signatures by June 26 to make it to the ballot.

“Since Dobbs, we have not been taking anything for granted, and we recognize the need and the opportunity to double down by putting this in the Constitution,” Harmon said.

In some states, divides have formed over how access should be protected. Recent abortion rights initiatives in Michigan and Ohio have prevented states from restricting access before fetal viability, unless the life or health of the pregnant person is at risk.

But efforts to restore abortion access in Arkansas and South Dakota – two states where the procedure is totally banned except to save the life of the pregnant patient – allow for more restrictions.

The Arkansas ballot initiative, which received approval to start gathering signatures in January, would prohibit the state from restricting abortion access within “18 weeks of fertilization” (20 weeks of pregnancy), with exceptions for rape, incest, fatal fetal abnormalities and to protect the physical health of the pregnant person.

And in South Dakota, a proposed constitutional amendment would block the state from restricting access during the first trimester. The state would be able to regulate abortion during the second trimester in ways related to the “physical health of the pregnant woman.” Lawmakers could prohibit abortion in the third trimester except when the procedure is necessary to protect the life of health of the pregnant person.

The local affiliates of Planned Parenthood and the American Civil Liberties Union that serve South Dakota and Arkansas have not endorsed the ballot initiatives.

Standiford said the measures “fell short” of their standard of providing the most expansive access. Her organization has no plans to help boost the South Dakota and Arkansas efforts at this time.

“In 2024, where Planned Parenthood Action Fund believes we must invest and engage is in those states where there is an opportunity to protect or restore an expansive right to abortion for as many patients as possible,” she said.

Toni Webb, the deputy director for ballot initiatives at the ACLU, made a similar argument.

“We need sufficiently robust and comprehensive protections for the right to abortion, including the strongest legal language possible that will guide a court in evaluating restrictions on abortion,” Webb said in a statement.

Webb said the ACLU and its affiliates are working on measures in Arizona, Florida, Colorado, Missouri, Montana, Nebraska, Nevada and New York and also “exploring ballot campaigns in upcoming years when the conditions will be right to successfully restore abortion rights in other states.”

The biggest struggle for grassroots groups who don’t have national support is fundraising. Arkansans for Limited Government, the coalition backing the abortion amendment in the state, has raised just $30,000.

Sam Watson, the content director for For AR People, part of the coalition backing the measure, acknowledged the group would ultimately need millions to fund the campaign. But they believe the language they crafted struck the right balance between what would provide the most protections and what would pass.

“In a very conservative state, the kind of viability line that those national groups are looking for just simply wouldn’t pass here,” Watson said.

The campaign has until July 5 to gather 90,700 valid signatures. Republican Gov. Sarah Huckabee Sanders signed a law last month raising the number of counties that ballot initiative campaigns must collect a minimum number of signatures from to 50, up from 15.

Rick Weiland, the chairman of Dakotans for Health, which is leading the South Dakota effort, said he was “disappointed” that the national groups have not gotten involved. He argued the amendment his group is promoting most closely resembles Roe v. Wade and pointed to federal data showing the overwhelming majority of abortions are performed in the first and second trimesters.

“This whole idea that we could go further – is that about helping people, or is that about making a point?” Weiland said. “We’re sitting here with no access and this amendment – which is Roe – provides access to 99%.”

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